PHARMACOGENETIC FACTORS IN THE DEVELOPMENT OF BEHAVIORAL ADVERSE REACTIONS WHILE TAKING ANTIEPILEPTIC DRUGS: A CLINICAL CASE

According to various studies, to date the frequency of various adverse reactions can reach 50 %.

Psychiatric and behavioral reactions, in particular aggression, are the most common, occurring in up to 20-30 % of patients using antiepileptic drugs. We offer clinical observation of a patient with structural epilepsy, who developed behavioral adverse reactions (aggression, irritability, impulsivity) during the initial administration of Levetiracetam, and therefore neuropsychological and pharmacogenetic testing was carried out. According to a pharmacogenetic study, carriage of single-nucleotide variants of genes was identified that predispose to changes in the metabolism of dopamine and serotonin, which increases the risk of aggressive behavior, including auto- and external aggression, also while taking a starting dose of Levetiracetam. Taking into account the clinical picture and specialized additional examination, the therapy was adjusted, including the abolition of Levetiracetam, which made it possible to stop unwanted reactions. This clinical case demonstrates the importance of personalized pharmacogenetic research in patients with epilepsy, which ensures more effective and safe therapy. This can significantly improve the quality of life of patients.

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